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Appendix A - Updated Shared Physician Recruitment Incentive Support Model - October 2023 Page 1 / 2 Shared Physician Recruitment Incentive Support Model – Family Physicians, Internal Medicine, Hospitalists, Emergency Medicine and Surgery Trained Physicians October 10, 2023 EXECUTIVE SUMMARY The purpose of this report to the Town of Tillsonburg Community Health Care Committee is to propose an amendment to the Physician Recruitment Incentive Support Model that is currently in place. BACKGROUND In January 2016, a Shared Physician Recruitment Incentive Support Model was implemented collaboratively between the Town of Tillsonburg and Tillsonburg District Memorial Hospital (TDMH). At that time, it was recognized that family physicians are critical to the town’s further growth and prosperity. In August of 2020, it was noted that three important factors had changed the landscape for physician recruitment, necessitating a re-evaluation of the incentive framework. First, it remains apparent that as the demographics of the population of our community ages the health care needs of our patient population have become increasingly complex necessitating the need to recruit physicians specially trained in areas like cardiology, respirology and gerontology. Secondly, the acuity of patients seen in our Emergency Department (ED) has increased. Lastly, our physicians are aging. Family physicians, with increasing frequency, are expressing the desire to limit their practice to their offices and are opting out of hospital based medicine. At present there are currently seven (7) family physicians in Tillsonburg who provide coverage of the Emergency Department with the assistance of Health Force Ontario physicians. Of note, one of the physicians is over the age of 60. Sources from both the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO) agree that an average age of 65 would be reasonable to assume as the time most physicians would cease to practice full-time. Our ED physicians have expressed that it is their opinion that 24/7 coverage by seven ED physicians is not sustainable and recruitment of additional ED physicians is crucial to maintain the present level of hospital service in Tillsonburg and surrounding area. These factors are driving the need for TDMH to recruit specialist physicians in Internal Medicine, Hospitalists, Surgeons and also ED Trained Physicians. The elements described above are creating an unprecedented pressure to recruit physicians into our community; however, we are experiencing difficulty in attracting these skilled professionals. As highlighted in the past and what is still relevant today in 2023 is that financial incentives have and will increase the probability in the future of physicians relocating to the community. Page 2 / 2 OBJECTIVE To ensure the ongoing sustainability/viability of the hospital is imperative that physicians with appropriate training are available to service the community. As such we are recommending the following financial incentive model for all physicians recruited into our community including family physicians and specialty trained physicians. Shared Physician Recruitment Incentive Support Model Details: FAMILY PHYSICIAN SPECIALTY PHYSICIAN • Contribute up to $5,000.00 in moving expenses for relocation to Tillsonburg (with appropriate receipts). • The physician recruit must reside within 15 kilometers of Tillsonburg. NOTE: IF physician is relocating from outside of Ontario, the incentive is increase to $10,000 $5,000.00 $10,000.oo • Contribute up to $5,000.00 in moving expenses for relocation to Tillsonburg (with appropriate receipts). • The physician recruit must reside within 15 kilometers of Tillsonburg NOTE: IF physician is relocating from outside of Ontario, the incentive is increase to $10,000 $5,000.00 $10.000.00 • Six months of housing support up to $7,350.00. $7,350.00 • Six months of housing support up to $7,350.00. $7,350.00 • Up to $10,000 for Clinic space and equipment updates, to the Clinic that will employ the physician recruit (with appropriate receipts) (i.e. Electronic Medical Record, new equipment) $10,000.00 • Clinic space including payment for clerical support to manage bookings, office visits and patient records for up to six months. This is not a permanent arrangement and the Hospital will work with the recruit to develop a clinic within the hospital that is cost neutral to the Hospital. $10,000.00 • Maximum $6,000 per month, for the first six months, payable to the physician recruit toward clinic overhead costs (with appropriate receipts). $36,000.00 • Stipend of $30,000 based on a five-year return of service agreement for full service to the hospital and community; $30,000.00 • The Family Physician commitment to the hospital and the community will include:  a five-year return of service agreement;  work a minimum of four (4) full days of office practice; and  Practice in the hospital (i.e. ED work, Hospitalist, Surgical Assistant). TOTAL INCENTIVE $58,350.00 $52,350.00 TOTAL INCENTIVE IF PHYSICIAN MOVING OUT OF PROVINCE $63,350.00 $57,350.00 The total amount that could be reimbursed per recruit, based on the proposed support model will be a 50/50 split between the Town of Tillsonburg and TDMH.